Non-Pharmacological Treatments in Rheumatoid Arthritis

Rheumatoid Arthritis Physiotherapy & Exercise

Physiotherapy and exercise are integral to the long-term management of patients with rheumatoid arthritis. Maintaining function and strength of muscles and joints is important in order to prevent and limit joint destruction. Rheumatology departments will have physiotherapists working within their multi-disciplinary team who are expert in dealing with patients with inflammatory arthritis. Patients are usually referred to them by their consultant or specialist nurse as part of their usual care. Patients are also able to self refer for further input as required.

For more information on exercise visit:
Arthritis Research UK www.arthritisresearchuk.org/arthritis-information/exercises-to-manage-pain.aspx

For local services and referral information visit:
University Hospitals Bristol NHS Foundation Trust www.uhbristol.nhs.uk/for-clinicians/our-clinical-services/physiotherapy-musculoskeletal/

North Bristol NHS Trust www.nbt.nhs.uk/clinicians/services-referral/physiotherapy-clinicians

Bristol City Council www.bristol.gov.uk/page/adult-care-and-health/exercise-referral-scheme

Rheumatoid Arthritis Occupational Therapy

Occupational therapists are also an integral part of the rheumatology multi disciplinary team. They specialise in hand therapy and improving function in day to day tasks. They can also provide and advise on devices such as splints.

Patients are usually referred by their specialist teams as part of their usual care, but they are also able to self refer once established in the service.

For local services and referral information visit:
University Hospitals Bristol NHS Foundation Trust www.uhbristol.nhs.uk/patients-and-visitors/your-hospitals/other-services-in-bristol/occupational-therapy/

North Bristol NHS Trust www.nbt.nhs.uk/clinicians/services-referral/occupational-therapy-clinicians

Rheumatoid Arthritis Podiatry

Podiatrists specialise in assessing and managing foot problems. Referrals to podiatry are made through the specialist teams or from the community. 

Rheumatoid Arthritis Orthotics

Orthotics specialises in providing aids and supports for joints such as shoe inserts, splints and braces. Simple orthotic devices can be purchased over the counter but more specialist devices require assessment by an orthotist, physiotherapist or occupational therapist. Orthotics referrals are made via the specialist teams or from the community

Rheumatoid Arthritis Psychology

Psychology input can be very useful in rheumatoid arthritis in terms of developing techniques for coping and self management. North Bristol NHS Trust is lucky enough to have a clinical psychologist as part of the rheumatology multidisciplinary team and referrals are made via the consultant or specialist nurse.

For local services and referral visit:
North Bristol NHS Trust www.nbt.nhs.uk/clinicians/services-referral/psychology-clinicians

www.nbt.nhs.uk/clinicians/services-referral/rheumatology-clinicians

Rheumatoid Arthritis Hydrotherapy

Hydrotherapy is water based physiotherapy and this can be beneficial in rheumatoid arthritis patients.  Many sessions are run as groups by the physiotherapy team and patient suitability for these sessions is assessed by the physiotherapist.

Rheumatoid Arthritis Surgery

When significant joint dysfunction or pain occurs despite treatment with DMARDs and input from the multidisciplinary team, then referral for surgical intervention can be considered. Most rheumatology departments run combined clinics with the orthopedic surgeons in which patients can be assessed by both a rheumatologist and a surgeon and sometimes other members of the multidisciplinary team eg physiotherapist. Patients are usually referred to these clinics by members of the rheumatology multidisciplinary team. Patients can also be referred to orthopaedic clinics direct from primary care.

For more information on rheumatoid arthritis surgery visit:

NICE cks.nice.org.uk/rheumatoid-arthritis#!scenariorecommendation:5